"I feel like I’ve made a difference in someone’s life."

Thomas Story rose in the middle of the night to take his place in a line of eastern North Carolinians, already 50-deep before dawn and certain to grow longer. For Story, 62, and 8,252 others seen by a dentist during one of 12 mobile clinics held by the North Carolina Dental Health Fund’s Missions of Mercy (MOM) across the state last year – the wait was a small price to pay for relief from decaying teeth, pain and infection.

Story had all of his teeth pulled that day in Washington, N.C. – an hour’s drive from the farm community where he lives in Perquimans County. “They had to come out because I had waited too late,” said Story. “A dentist was too far away, and I mean it would just cost so much to just pull one tooth.”

There are 2.2 dentists for every 10,000 people in Perquimans County and no community health centers. The state average is 4.4 dentists for every 10,000 people, and the national average is 6 dentists for 10,000 people. Four eastern North Carolina counties have no dentist at all.

It’s a situation that has forced many of our neighbors to turn to hospital emergency departments for help when dental pain has crippled them to the point that they can’t work, or their overall health has been impacted. The uninsured often neglect preventive dental care and frequently put off emergency treatment. Just over 50 percent of all North Carolinians see a dentist in a calendar year. Low income, and rural communities in particular, have limited and often, inadequate access to oral health services. The Blue Cross and Blue Shield of North Carolina Foundation has taken several approaches to address this gap in care — two recent investments, which directly address improving access for uninsured populations, are profiled here:

Greene County Health Care, Inc.
Through a partnership with the DentaQuest Institute and local clinics such as Greene County Health Care, Inc., dental clinics are increasing their capacity to serve patients and are improving their financial sustainability. Although many health departments, community health centers, rural health centers, free clinics and other providers are committed to providing care to the underserved, there is great variety in dental productivity rates and financial stability among these providers. Through the Foundation’s “Strengthening the Oral Health Safety Net” project, dental clinics that provide care to the uninsured on a regular basis receive consulting services that support them in making changes to their practice. These small changes help participating clinics to serve more patients and to secure their bottom line, setting the stage for care into the future. In the first year of the project, clinics that were able to implement recommended changes decreased operating deficits by 50 to 70 percent, and many clinics increased the number of treatments provided by more than 50 percent.

Missions of Mercy
The North Carolina Dental Health Fund’s Missions of Mercy (MOM) program provides limited free care to uninsured adults at a dozen two-day clinics held in churches, convention centers and schools across the state. The program saw a dramatic improvement in the quality of care and the number of uninsured North Carolinians receiving free dental care during the first calendar year of operation with a new mobile X-ray unit paid for by a BCBSNC Foundation grant. There was a 28 percent increase in the number of patients seen compared to the previous year, and 75 percent of patients received X-rays prior to treatment. Donated dental services valued at $4.2 million were provided to 8,253 patients last year. While communities that host NC MOM clinics experience an immediate and steep decrease in demand for emergency dental care at hospital emergency departments following a clinic, the Foundation is also working to develop resources to provide more consistent access to preventive and follow-up dental care for patients in communities throughout North Carolina.

In August of 2011, as a result of funding in the Affordable Care Act, the federal government announced that a new federally qualified health center will be established in Gatesville and Tyner to address access to dental care for Thomas Story and other North Carolinians in Perquimans, Gates and Chowan counties.

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